Neurosurgery has much to offer in the treatment of peripheral neuropathic pain but selection of the best procedure for a given patient remains problematic: planning of the treatment must be based on an analysis of the pathophysiological mechanism in the given case but the identification of this mechanism is often difficult. Available procedures are: 1) Nerve repair, neurolysis and nerve relocation; 2) Interventions on the sympathetic nervous system; 3) Neurostimulation; 4) Intraspinal morphine; 5) Ablative lesions. Neurosurgeons have, or should have, the necessary neuroscience background and microsurgical skills to be important partners of the team caring for patients with peripheral neuropathic pain.